陈旧性心肌梗死并心力衰竭患者血浆N末端B型利钠肽原、C反应蛋白水平变化及其临床意义  

Changes and Clinical Significances of Plasma NT-proBNP and CRP Levels of Old Myocardial Infarction Patients Complicated with Heart Failure

作　　者：吴颖[1] 严卫国[1] 曹立平[1] 夏林凤 

机构地区：[1]安徽省安庆市第一人民医院心内一科,246003

出　　处：《实用心脑肺血管病杂志》2015年第6期13-15,共3页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：目的观察陈旧性心肌梗死并心力衰竭患者血浆N末端B型利钠肽原(NT-proBNP)、C反应蛋白水平变化,并探讨其临床意义。方法选取安庆市第一人民医院心内科2011年2月—2014年9月收治的陈旧性心肌梗死患者287例,根据纽约心脏病学会(NYHA)心功能分级标准分为心力衰竭组133例和非心力衰竭组154例,比较两组患者临床特征及血浆NT-proBNP、C反应蛋白水平,观察心力衰竭组不同NYHA心功能分级患者血浆NT-proBNP、C反应蛋白水平变化。结果两组患者性别、年龄、高血压发生率比较,差异无统计学意义(P>0.05);心力衰竭组患者心率、体质指数、左心房内径、血浆NT-proBNP及C反应蛋白水平、糖尿病发生率、冠状动脉旁路移植术治疗率高于非心力衰竭组,左心室射血分数、经皮冠状动脉介入治疗率低于对照组(P<0.05)。NYHA心功能分级Ⅳ级患者血浆NT-proBNP、C反应蛋白水平高于Ⅲ级、Ⅱ级患者,NYHA心功能分级Ⅲ级患者血浆NT-proBNP、C反应蛋白水平高于Ⅱ级患者(P<0.05)。结论陈旧性心肌梗死并心力衰竭患者血浆NT-proBNP、C反应蛋白水平明显升高,临床可通过监测陈旧性心肌梗死患者血浆NT-proBNP、C反应蛋白水平来判断其心功能,以早期发现心力衰竭。Objective To observe the changes of plasma NT-proBNP and CRP levels of old myocardial infarction patients complicated with heart failure,to investigate their clinical significances. Methods A total of 287 patients with old myocardial infarction were selected in the First People＇ s Hospital of Anqing from February 2011 to September 2014,and they were divided into groups A（ with Ⅰ NYHA classification,n = 154） and B（ with Ⅱ to Ⅳ NYHA classification, n = 133）according to NYHA classification. Clinical features,plasma NT-proBNP and CRP levels were compared between the two groups,plasma NT-proBNP and CRP levels with different NYHA classifications in B group were observed. Results No statistically significant differences of gender,age or incidence of hypertension was found between the two groups（ P〉0. 05）. Heart rate,left atrial diameter, plasma NT-proBNP and CRP levels, incidence of diabetes and CABG rate of B group were statistically significantly higher than those of A group,while BMI,left ventricular ejection fraction and PCI rate of B group were statistically significantly lower than those of A group（ P〈0. 05）. Plasma NT-proBNP and CRP levels of patients with Ⅳ NYHA classification were statistically significantly higher than those of patients with Ⅱ to Ⅲ NYHA classification, and plasma NT-proBNP and CRP levels of patients with Ⅲ NYHA classification were statistically significantly higher than those of patients with Ⅱ NYHA classification（ P〈0. 05）. Conclusion Plasma NT-proBNP and CRP levels of old myocardial infarction patients complicated with heart failure are significantly increased,monitoring the plasma NT-proBNP and CRP levels of old myocardial infarction patients is helpful to estimate the cardiac function and early diagnose heart failure.

关 键 词：心肌梗死 心力衰竭 利钠肽 脑 C反应蛋白质 

分 类 号：R542.22[医药卫生—心血管疾病]